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Wheeless' Textbook of Orthopaedics

The early management of open joint injuries. A prospective study of one ³


hundred and forty patients. Patzakis MJ. Dorr LD. Ivler D. Moore TM. Harvey JP Jr. Journal of Bone & Joint Surgery - American. [JC:hjr] 57(8):1065-70, 1975 Dec. A study of open joint injuries treated at the Los Angeles County -University of Southern California Medical Center from July 1969 through July 1973 showed that the vast majority of these injuries were at the knee. Three types of injury were identified: those associated with fractures, injuries without fracture, and gunshot wounds. All patients were treated with antibiotics, surgical debridement and irrigation, and installation of polyethylene tubes into the joint as a system of postoperative closed irrigation. The over-all infection rate was 2.1 per cent. The results of treatment indicate that the irrigation system can be a source of contamination. Our recommended treatment for open wounds in joints is wide-spectrum systemic antibiotics, surgical debridement, irrigation of the joint and soft tissues, and primary closure. Prolonged suction-irrigation treatment postoperatively should only be done for specific indications: excessive contamination or excessive tissue damage when the wound to the joint should be closed primarily.



Original Text by Clifford R. Wheeless, III, MD.